Depression treatment: say no to drugs

Further evidence is emerging that anti-depressant drugs do not work for people with mild or moderate depression.

A study published in the latest journal of the American Medical Association reviews two decades of anti-depressant trials.

In all the tests patients were treated with anti-depressants or sugar pill placebos for at least six weeks.

The conclusion reinforces conventional wisdom that anti-depressants may be of little or no benefit for people with mild or moderate symptoms.

Jon Jureidini, the head of the Department of Psychological Medicine at the Women's and Children's Hospital in Adelaide, says the majority of people with mild depression who take anti-depressants get better.

"But the reality is that they would have got better if they hadn't taken the anti-depressants," he said.

When controlled clinical trials of anti-depressants are conducted, the placebos get pretty good results.

"The whole context in which the study occurs, with the questionnaires and the attention from the experimenters, all of those things benefit depression almost as much, or in the case of mild depression, just as much as getting drugs does."

To effectively treat mild and moderate cases of depression, clinical psychologists have had to try other approaches.

Amanda Gordon, president of the division of professional practice of the International Association of Applied Psychology, says there is good evidence that psychological therapies make a difference.

"If you believe that you are ineffective in anything you do, then a skilled therapist will help you find those areas in your lives in which you are effective," she said.

"(They) help you to focus on those things and actually find evidence of the effectiveness by the things that you do in the moment to help you become more effective.

"And through doing that you change your belief about yourself and your effectiveness, and in so doing also change your mood."

Ms Gordon says people have to make the right choices in life, and "sometimes the choice is to stay in the dead-end job because it's providing you with the income you need".

"But that's still a choice, a positive choice in your life," she said.

"I think well-meaning GPs who want to help people feel different in the immediacy have been writing prescriptions because that does seem to meet the needs of the person at the time.

"The problem is, not only has it been found to not be particularly effective with people with mild to moderate depression, it can sometimes make people feel even more hopeless."

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